PB2369: PERIPHERAL T CELL LYMPHOMA: EPIDEMIOLOGY AND CLINICAL CHARACTERISTICS
Authors: Maha Charfi, Noura Ben Yahia, Faten Kallel, Imen Frikha, Yousra Fakhfakh Derbel, Olfa Kassar, Imen Ben Amor, Khelifa Latifa, Sondes Hadiji Mseddi, Moez Medhaffar, Moez Elloumi
Journal: HemaSphere (2023)

Topic: 19. Aggressive Non-Hodgkin lymphoma - Clinical Background: Peripheral T cell lymphoma (PTCL) is a rare and heterogeneous group of non-Hodgkin’s lymphomas with a poor prognosis. They constitute a real problem given the absence of a well-codified therapeutic consensus. Aims: The aim of our work is to describe the prognostic and therapeutic aspects of PTCLs diagnosed and treated in south Tunisia and to compare our therapeutic results with literature data. Methods: Our study is retrospective. It concerned patients with PTCL excluding Natural Killer T cell lymphomas followed and treated in the clinical hematology department of the university hospital of Sfax during 22 years from January 2000 to June 2021. We used the International Prognostic Index (IPI) to evaluate the prognosis. Patients received anthracyclines-based therapeutic protocols, including mostly Cyclophosphamide, Adriamycin, Vincristine, Prednisone (CHOP) protocol and Cyclophosphamide, Adriamycin, Vincristine, Etoposide, Prednisone (CHOEP) protocol or other anthracycline based protocols. Autologus stem cell transplantation (ASCT) was indicated for patients aged 60 and younger with aaIPI superior to 1. Survival curves were measured using Kaplan Meier’s methods. Results: Fifty-two patients diagnosed with PTCL were registered. The most common histological type was peripheral T-cell lymphoma not otherwise specified (PTCL NOS) (27%) followed by anaplastic ALK negative T-cell lymphoma (ALCL ALK-) (23%). The median age was 49 years with a sex ratio of 2,2. A performance status equal or superior to 2 was present in 38.5% of patients. An extended stage (III-IV) was found in 85% of patients. 38.5% of patients had an IPI score superior to 1. The overall remission rate (ORR) was 44% and the complete response (CR) rate was 36,5%. The ALCL ALK positive and ALK negative had the best ORR of 66% each and the worst outcome was found in cutaneous T-cell lymphoma (ORR of 10%). The treatment response was influenced by the disease staging (p=0,011). The refractory and relapse rate was 55%, only 52% of cases received second line chemotherapy and the ORR was 20%. The 5-year overall survival (OS) and event-free survival (EFS) rates were respectively 29% and 27%. The highest 5- year OS rate was seen in ALCL ALK positive (66%). The univariate study showed that OS was influenced by the PS (p=0,0001), the IPI score (p=0,049) and the stage of the disease (p=0,002) while EFS was influenced by PS (p=0,001), disease stage (p=0,002) and response to treatment (p=0,001). Summary/Conclusion: Our results were similar to the literature data in terms of therapeutic response with an ORR of 60 to 83% and a CR of 22 to 68%. However, the survival results were inferior to reported literature (5- year OS of 34 to 70%). This, probably, can be improved with better adaptation of treatment to each entity of PTCL. Keywords: Chemotherapy, Malignant lymphoma, T cell lymphoma, Peripheral T-cell lymphoma